HomeMy WebLinkAboutS_Permit_Bond_PB01649700085_180215.pdf4’.-PrnitFormResetFormSivoFormJDT—Renton0PERMITBONDBondNumber:PB01649700085ProjectName:SenzaLakeviewKNOWALLMENBYTHESEPRESENT;thatweiCapLakeview,LLCofaWashingtonLimitedliabilityCompanyasPrincipal,andPhiladelphiaIndemnityInsuranceCompanyaCorporation,asSurety,areheldandfirmlyb&nduntqtheCityofRenton,amunicipalcorporationoftheStateofWashington,inthesumof864,559.44lawfulmoneyoftheUnitedStatesofAmerica,forthepaymentofwhich,willandtrulytobemade,wefirmlybindourselves,andeachofourheirs,executors,administratorsandassigns,jointlyandseverallybythesepresent.THECONDITIONOFTHEFOREGOINGOBLIGATIONSISSUCH,thatWHEREAS,theabovenamedPrincipalhasappliedforapermit,pursuanttotheprovisionsofOrdinanceNo.3205,todocertainworkonaCityofRentonroadway,street,alley,avenue,orotherpublicplace,duringape
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_NOWTHEREFORE,iftheabovenamedPrincipalshallindemnifyandsaveharmlesstheCityofRenton,fromallclaims,actionsordamagesofeverykindanddescription,whichmayaccrueasaresultofopeningand/orworkinguponaroadway,street,alley,avenue,publiceasement,orotherpublicplace,byhimorthoseinhisemploy,ininstallingormakingconnectionswithanypublicorprivatesewerorwatersystem,oranyotherpurposeorobjectwhatever,andthathewillreplaceandrestoresuchroadway,street,avenue,alleyorotherpublicplacetoasgoodastateorconditionasatthetimeofthecommencementofsaidwork,andmaintainthesameingoodordertothedecidedsatisfactionoftheCityofRenton,andthathewillcomplywithallprovisionsofhisortheirfranchiseofourpermitandallresolutionsorinstrumentsrelatingthereto,thisobligationtobevoid;otherwisetoremaininfullforceandeffect.Theliabilityunderthisbondisforaperiodofoneyearfrom02/15/2018to02/15/2019andmaybeextendedbythesuretyissuingaContinuationCertificate._
__BY:1SignatureofBondingAgentAndrewP.LarsenAttorney-in-factAttachPowerofAttorneyFormtoBond_____________________________________Includecontactinformation.2233112thAveNEBerlevue,WA98004AgentAddress____________________________________________________425-709-3600contactNumberBY:Sealedwithoursealsanddatedthis15dayofFebruary2018Th4zzflrfl/>AppIicant’sSigne/3535FactoriaBlvd.SEApplicant’sAddressBellevue,WA98006City,State,ZipH:\CED\Oata\Forms-Templates\self-HeIpHandouts\PublicWorks\PERMITBOND.docxRev:04/2015
d573PIIILDELPlILINDEMNITYINSIRASCECOMPANYOneBalaPlaza,Suite100BalaCynw;d.PA19004-0950PojcrofAttorneyKNOWALLPERSONSBYTIIESEPRESENTS,ThatPIIILkDELPIIL%INDEMNITYINSURANCECOMPANY(theCompany),acorporationorganizedandexistingundertheIa”softheCommonssealtlirifPennsylvaniadoesherebyconstituteandappointChrktin‘1.hobble.DeannaM.French.ElizabethR.hahn.GuyArmfltld,JanaM.Rov.,IenniIcrI,,Schultz,JillA.Wallace,JohnR.Claevs,NiadeI.Matetich,MmdccI..Rankin.Ro2crKaltenhach,Ronald.1.tanee,SandyI.Boswetl,ScottFisher,ScullMeGilyrny,SusanH.LarsonandAndrewP.LarsenofParker,Smith&Feek.Inc.itstrueandlawfulAttorney-in-factwiti,fullauthorityInexecuteonitsbehalfbonds,undertakings,recognizaneesandothercontractsofindemnityandwritingsobligatoryinthenaturethereof,issuedinthecourseofitshusinessandtohindtheCompanythereby,inanamountnottoexceed525.00lI,000.00.ThisPowerofAttorneyisgrantedandissignedandsealedbyfacsimileunderandbytheauthorityofthefollowingResolutionadoptedbytheBoardofDirectorsofP[tILADELPIIIAINDEMNITYINSURANCECOMPANYonthet4’ofNovember,2016.RESOLVED:ThattheBoardofDirectorsherebyauthorizesthePresidentoranyVicePresidentoftheCompany:(I)AppointAttorney(s)inFactandauthorizetheAttorney(s)inFacttoexecuteonbehalfoftheCompanybondsandundertakings,contractsofindemnityandotherwritingsobligatoryinthenaturethereofandtoattachthescatoftheCompanythereto;and(2)toremove,atanytime,anysuchAttorney-in-Factandrevoketheauthoritygiven.And,beitThatthesittnaturesofsuchofficersandtheseatofsheCompanymaybeaffixedtoanysuchPowerofAttorneyorcertificaterelatingtheretobyfacsimile,andanysuchPowernfAttorneysoexecutedandcertifiedbyfacsimilesienatumsandFacsimilesealshallbealidandbindingupontheCompanyinthefuturewithrespecttoanybondorundertakingtowhichitisattached.tNTESTIMONYWHEREOF.PHILADELPHIAINDEMNITYINSURANCECOMPANYHASCAUSEDTHISINSTRUMENTTOBESIGNEDANDITSCORPORATESEALTOBEAFFIXEDBYITSAUTHORIZEDOFFICETHIS27”DAYOFOCTOBER.2017.RobertD.O’LearyJr.,President&CEOPhiladelphiaIndemnityInsuranceCompanyOnthis275dayofOctober,2017,beforemecametheindividualwhoexecutedtheprecedinginstrument,tomepersonallyknown,andbeingbymedulyswornsaidthatheisthethereindescribedandauthorizedofficerofthePhILADELPhIAINDEMNITYINSURANCECOMPANY;thatthesealaffixedtosaidinstrumentistheCorporatesealofsaidCompany;thatthesaidCorporateSealandhissignatureweredulyaffixed.COUMO%WEAçTWOFflN4SVLVaIisoIA;aLA;&IA’1•appN..I.Psi;,LA_eD.,M.C.,,,,,.I,(,i,,..5.,i:.;:2i_,I.EdwardSaago,CorporateSecretan’ofPHILADELPHIAINDEMNITYINSURANCECOMPANY,doherehycertifythattheforegoinaresolutionoftheBoardofDirectorsandthisPowerofAttt,rneyissuedpursuanttheretoonthis27dayofOctober,2017aretrueandcorrectandarestillinfoilforceandeffect.IdofurthereertiIthatRobertD.O’LearyJr.,whoexecutedthePowerofAttorneyas‘resident,wasonthedateofexecutionoftheattachedPowerofAttorneythedulyelectedPresidentofPIiILADELPIIIAINDEMNITYINSURANCECOMPANY,InTestimonyWhereoflhavesuhscribedmynameandalflxedthethcsimilesealafeachCompanythisl3dayofFccaoj&.ILI)927-EdwardSayago.CorporateSecretary-.:.nIILADELPIIIAINDEMNITYINStRANCECOMPANY••FURTHERRESOLVED:(Seal)I927’:tNotatySeal)NotaryPublic:residingat:Mycommissionexpires:RaIaCvnw’d.PASeptember25.202!